{
  "abstract": "Objectives Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a systemic autoimmune disease where infections can trigger relapses. Dental infections, being common and associated with systemic inflammation, may play a role in AAV relapse, though their impact remains unclear. We aimed to evaluate the association between severe dental infections and early relapse in patients with AAV.Methods This retrospective cohort study included patients newly diagnosed with AAV between January 2011 and July 2022. Patients with severe dental infections requiring tooth extraction were placed in the dental infection group, while the remaining patients were assigned to the control group. The primary outcome was defined as either vasculitis relapse or all-cause mortality within 1 year of treatment initiation. Adjusted HRs (aHRs) and 95% CIs were estimated using Cox proportional hazards models.Results A total of 93 patients were enrolled with a median age of 74 years. 41 patients (44.1%) had severe dental infections in this cohort. Over the 1-year follow-up period, 13 patients experienced a relapse and two died, resulting in a composite event rate of 20.9 per 100 person-years. Dental infection was independently associated with the composite outcome (aHR, 3.78 (95% CI 1.13 to 12.66); p=0.031). Exploratory analysis indicated that composite outcome rates were similar regardless of tooth extraction among patients with dental infections.Conclusions Severe dental infections were associated with increased risk of early relapse or mortality in AAV. These findings highlight the importance of early dental evaluation in AAV management.",
  "authors": [
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Shoichi Nawachi"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Takayuki Katsuyama"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Yoshia Miyawaki"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Moe Sakamoto-Tokunaga"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Natsuki Kubota"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Yuya Terajima"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Kazuya Matsumoto"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Kei Hirose"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Takato Nakadoi"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Manami Hirata-Watanabe"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Yu Katayama"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Keigo Hayashi"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Haruki Watanabe"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan",
        "Department of Medical Laboratory Science, Okayama University Graduate School of Health Sciences, Okayama, Japan"
      ],
      "name": "Eri Katsuyama"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Mariko Takano-Narazaki"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan",
        "Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Shigetomo Tsuji"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Yoshinori Matsumoto"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan",
        "Department of Clinical Epidemiology, Kochi Medical School, Kochi University, Nankoku, Japan"
      ],
      "name": "Ken-Ei Sada"
    },
    {
      "affiliations": [
        "Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"
      ],
      "name": "Jun Wada"
    }
  ],
  "title": "Dental infection is associated with early relapse in patients with ANCA-associated vasculitis",
  "uid": "6c1ea161-b113-5146-81a6-e16908539646"
}